Autologous blood stem cell transplantation for chronic granulocytic leukaemia in transformation: a report of 47 cases

Abstract

Forty-seven patients with chromosome Philadelphia-positive (Ph1) chronic granulocytic leukaemia (CGL) in transformation underwent autologous transplantation of peripheral blood stem cells (ABSCT) collected at the original diagnosis before any treatment. They were treated with three consecutive strategies: single transplant (group I = 17 patients), double transplant (group II = 13 patients), double transplant followed by recombinant alpha interferon (group III = 17 patients). Forty-three patients were restored to a second chronic phase with a cytogenetic conversion (more than 10% Ph1-negative marrow metaphases) occurring in 14 of the 29 evaluable patients. Most patients had a recurrent transformation occurring 2-43 months after ABSCT and finally eight patients are still alive in second chronic phase 4-49 months after ABSCT (median = 24 months). The actuarial median duration of second chronic phase was 3 months, 10 months and 18 months for group I, group II and group III patients (P less than 0.0001). The encouraging results observed for group III patients prompt us to propose ABSCT for patients in chronic phase with initial prognostic factors, suggesting that recombinant alpha interferon will not be effective if administered as front-line therapy.

Mobilisation of haemopoietic progenitors in CML: a second course of intensive chemotherapy does not improve Ph-negativity in stem cell harvests

“…38 In addition, it has been shown that patients who do not respond cytogenetically to IFN␣, may revert to IFN␣ exactly evident from (n = 12)/ +G-CSF paper; 41% of (n = responsiveness after intensive chemotherapy and autoSCT. 39,40 All these studies suggest an additive effect of intensive chemotherapy to an already impressive antileukaemic activity of IFN␣ alone. A prospective randomised trial under the auspices of the EBMT addressing the question whether autoSCT followed by IFN␣ vs IFN␣ alone improves survival is currently being performed.…”

Autologous transplantation for chronic myelogenous leukemia with mafosfamide‐treated marrow

“…Several approaches have been proposed to purge autologous marrow in vitro to favor hematopoietic reconstitution with Ph-negative cells [ 151. These approaches include: 1) purging with chemotherapy [16][17][18] or interferon [19], 2) in vitro selection by growth in long-term culture [20], and 3) in vivo therapy with combinations of antileukemic agents or with interferon-alpha followed by transplant [21,22]. The use of peripheral blood progenitors has also been proposed [23,241.…”

All-trans retinoic acid potentiates the inhibitory effects of interferon α on chronic myeloid leukemia progenitors in vitro

“…5 The cells belonging to the before any treatment. 21 All patients were in chronic phase, malignant clone can be detected by either chromosome with 100% Ph-positive metaphases in cytogenetical analysis. analysis or techniques designed to monitor the expression of Informed consent was given in every case.…”